Claims Implementation Leader: Strategy & Delivery

Centene Corp.; Northern (KY); Hybrid; USD 148,000 - 274,000; Full time

Job summary

Centene Corp. is seeking a senior leader to oversee the implementation of health plan products into Claims operations in the United States. You will ensure alignment with strategy, standardize the implementation processes, and manage regulatory and contract changes across new markets.

You will direct BRD approvals, help shape operating models, ensure budgets and timelines are met, and provide strategic guidance for New Health Plan Implementations.

Qualifications

• Bachelor's degree or equivalent experience.
• 7+ years of project management experience.
• 5+ years of Government Programs Managed Care experience.
• Medicaid Managed Care experience preferred.
• Experience with BRD approvals and regulatory changes.

Responsibilities

• Oversee the implementation of products/plans into Claims units.
• Direct creation and maintenance of standard claims models.
• Provide strategic leadership of claims implementations.
• Ensure adherence to standard processes and BRD approvals.
• Contribute to operating models, performance metrics and plan impacts.
• Direct implementations to meet budget, timeline and scope.
• Develop timelines for new health plan implementations.

Skills

Project management

Leadership

Government programs

Claims implementation

Budget management

Timeline management

Education

Bachelor's degree

Master's degree

Job description

Centene Corp. is seeking a senior leader to oversee the implementation of health plan products into Claims operations in the United States. You will ensure alignment with strategy, standardize the implementation processes, and manage regulatory and contract changes across new markets.

You will direct BRD approvals, help shape operating models, ensure budgets and timelines are met, and provide strategic guidance for New Health Plan Implementations.